Magnetic resonance studies of intramuscular interferon β–1a for relapsing multiple sclerosis

Abstract

The Multiple Sclerosis Collaborative Research Group trial was a double-blind, randomized, multicenter, phase III, placebo-controlled study of interferon beta-1a (IFNbeta-1a; AVONEX) in relapsing forms of multiple sclerosis. Initial magnetic resonance imaging results have been published; this report provides additional results. Treatment with IFNbeta-1a, 30 microg once weekly by intramuscular injection, resulted in a significant decrease in the number of new, enlarging, and new plus enlarging T2 lesions over 2 years. The median increase in T2 lesion volume in placebo and IFNbeta-1a patients was 455 and 152 mm3, respectively, at 1 year and 1,410 and 628 mm3 at 2 years, although the treatment group differences did not reach statistical significance. For active patients, defined as those with gadolinium enhancement at baseline, the median change in T2 lesion volume in placebo and IFNbeta-1a patients was 1,578 and -12 mm3 and 2,980 and 1,285 mm3 at 1 and 2 years, respectively. Except for a minimal correlation of 0.30 between relapse rate and the number of gadolinium-enhanced lesions, correlations between MR and clinical measures at baseline and throughout the study were in general poor. Once weekly intramuscular IFNbeta-1a appears to impede the development of multiple sclerosis lesions at an early stage and has a favorable impact on the long-term sequelae of these inflammatory events as indicated by the slowed accumulation of T2 lesions.

Evolution of Cortical and Thalamus Atrophy and Disability Progression in Early Relapsing-Remitting MS during 5 Years

“…Placebo-controlled clinical studies have shown that intramuscular interferon ␤-1a slows disability progression, 41 reduces T2-lesion volume, 42 and prevents atrophy. [23][24][25][26]43 Despite these known effects of treatment with intramuscular interferon ␤-1a, both patients with SDP and those with stable MS exhibited loss of brain tissue during the course of this study.…”

Review of automatic segmentation methods of multiple sclerosis white matter lesions on conventional magnetic resonance imaging

“…Over the last decade, a number of immunomodulatory and immunosuppressive therapies have been approved for clinical use based primarily on demonstration of their ability to suppress focal inflammatory activity, i.e., lesion formation, and clinical relapses (Comi et al, 2001;Leary et al, 2003;Li and Paty, 1999;Li et al, 2001;Miller et al, 1999;Paty and Li, 1993;Simon et al, 1998;Simon et al, 2000;Zhao et al, 2000). Development of these therapies has been critically dependent on MRI because of the ability of MRI to visualize lesion formation with an order of magnitude greater sensitivity than clinical observation is able to detect relapses The number and volume of MS lesions represent the "burden of disease" and are predictive of patients' clinical course over the long term (O'Riordan et al, 1998).…”

Neuroimaging in Multiple Sclerosis: Neurotherapeutic Implications

“…The original studies with interferon-β showed a dramatic reduction in Gd + activity [30] and subsequently a more modest decrease in relapse rate [31]. Treatment with the firstgeneration injectable therapies, such as interferon beta-1b (Betaseron; Bayer Healthcare Pharmaceuticals, Wayne, JF), and interferon beta-1a [Avonex (Biogen Idec, Weston, MA); Rebif (Merck Serono, Geneva, Switzerland)] and glatiramer acetatate (Copaxone; Teva Pharmaceuticals, Petah Tikva, Israel), leads to variable decreases in Gd + activity and the number and volume of T2 lesions [31][32][33][34][35][36][37] and, on average, a 30% reduction in relapses [7, 31, 36, 38, [36,[40][41][42].…”